Ryu Dae Gon, Choi Cheol Woong
Korean J Helicobacter Up Gastrointest Res. 2023 Mar;23(1):7-14. doi: 10.7704/kjhugr.2023.0014. Epub 2023 Mar 9.
Indefinite-for-neoplasia is an expression used to describe lesions in which carcinoma or dysplasia cannot be clearly and conclusively established via biopsy. Gastric indefinite-for-neoplasia may represent a reactive change secondary to inflammation in some patients; however, some lesions are eventually diagnosed as dysplasia or carcinoma. Follow-up endoscopic biopsy is commonly performed in patients with gastric indefinite-for-neoplasia lesions. Nonetheless, patients may undergo resection based on a high index of clinical suspicion for dysplasia or carcinoma based on endoscopic findings. Accurate target biopsies of the lesion and effective communication with pathologists are required to improve diagnostic accuracy and avoid unnecessary re-examinations. It is important to establish endoscopic findings useful in differentiating lesions that require resection. In this review, we describe the approach for the management of indefinite-for-neoplasia lesions detected on gastric mucosal biopsy and the characteristics of lesions that require resection.
不能确定为肿瘤是一个用于描述通过活检无法明确且确凿地确诊为癌或发育异常的病变的术语。胃不能确定为肿瘤在某些患者中可能代表继发于炎症的反应性改变；然而，一些病变最终被诊断为发育异常或癌。对于胃不能确定为肿瘤的病变患者，通常会进行随访内镜活检。尽管如此，基于内镜检查结果对发育异常或癌的高度临床怀疑指数，患者可能会接受手术切除。为提高诊断准确性并避免不必要的复查，需要对病变进行准确的靶向活检并与病理学家进行有效的沟通。确定有助于区分需要手术切除的病变的内镜检查结果很重要。在本综述中，我们描述了胃黏膜活检中检测到的不能确定为肿瘤的病变的管理方法以及需要手术切除的病变的特征。
